Bottom Line:
USG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies.The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram.Associated truncal and chromosomal anomalies need to be identified.

ABSTRACTUSG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies. In fetal echocardiography, the four-chamber view and the outflow-tract view are used to diagnose cardiac anomalies. The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram. Associated truncal and chromosomal anomalies need to be identified. This review shows how fetal echocardiography, apart from identifying structural defects in the fetal heart, can be used to look at rhythm abnormalities and other functional aspects of the fetal heart.

Figure 0007: Hypoplastic left heart. USG image (A) shows an echogenic left ventricle (arrow). Doppler images (B,C) show absent flow on the left side (arrow in B), and reversal of flow in the aortic arch (arrow in C)

Mentions:
Hypoplastic left heart [Figure 7]: This is often associated with mitral atresia. The mitral valve is echogenic and does not move during the cardiac cycle. Since there is no flow across the mitral valve, the left ventricle fails to develop normally. The left ventricle is small, echogenic, and does not reveal any color flow. The arch of the aorta reveals reversal of flow, i.e., from the descending aorta into the arch and thence into the ascending aorta. The arch of the aorta fills in a retrograde manner from the ductus.

Figure 0007: Hypoplastic left heart. USG image (A) shows an echogenic left ventricle (arrow). Doppler images (B,C) show absent flow on the left side (arrow in B), and reversal of flow in the aortic arch (arrow in C)

Mentions:
Hypoplastic left heart [Figure 7]: This is often associated with mitral atresia. The mitral valve is echogenic and does not move during the cardiac cycle. Since there is no flow across the mitral valve, the left ventricle fails to develop normally. The left ventricle is small, echogenic, and does not reveal any color flow. The arch of the aorta reveals reversal of flow, i.e., from the descending aorta into the arch and thence into the ascending aorta. The arch of the aorta fills in a retrograde manner from the ductus.

Bottom Line:
USG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies.The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram.Associated truncal and chromosomal anomalies need to be identified.

ABSTRACTUSG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies. In fetal echocardiography, the four-chamber view and the outflow-tract view are used to diagnose cardiac anomalies. The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram. Associated truncal and chromosomal anomalies need to be identified. This review shows how fetal echocardiography, apart from identifying structural defects in the fetal heart, can be used to look at rhythm abnormalities and other functional aspects of the fetal heart.